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General NPI Number Information
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NPI Number | 1043692940
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Entity Type | Organization
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Legal Business Name | MENIFEE VALLEY CARDIOLOGY,INC
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Dates
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Enumeration Date | 06/26/2015
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Last Update Date | 06/26/2015
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Provider Practice Location Address
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Address Line | 28125 BRADLEY RD SUITE 260
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City | SUN CITY
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State | CA
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Zip | 92586-2248
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Country | US
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Telephone | 951-679-3131
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Fax | 951-679-3133
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Provider Business Mailing Address
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Address Line | 28125 BRADLEY RD SUITE 260
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City | SUN CITY
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State | CA
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Zip | 92586-2248
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Country | US
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Telephone | 951-679-3131
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Fax | 951-679-3133
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Authorized Official
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Title or Position | CARDIOLOGIST
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Name | DR. HUMAYUN T QURESHI
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Credential | MD
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Telephone | 951-666-1243
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | C51284
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License Number State | CA
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